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Evaluation of a single intra-articular injection of autologous protein solution for treatment of osteoarthritis in horses

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  • 1 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 2 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 3 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 4 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 5 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 6 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 7 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 8 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 9 South Towns Equine, 925 Quaker Rd, East Aurora, NY 14052.
  • | 10 Cleveland Equine Clinic, 3340 Webb Rd, Ravenna, OH 44266.

Abstract

Objective—To evaluate intra-articular autologous protein solution (APS) for the treatment of osteoarthritis in horses.

Animals—40 client-owned horses with naturally occuring osteoarthritis.

Procedures—APS was generated from a dual-device system that concentrated plasma and WBC proteins and enriched platelet growth factors. Horses were randomly assigned to receive an intra-articular injection of 5 mL of saline (0.9% NaCl) solution (n = 20) or APS (20), exercised on a treadmill, and evaluated on the basis of lameness grades, kinetic gait analysis, joint circumference, and range of motion for 14 days. Horses that received saline solution were administered APS at termination of the study, and clients scored horses for lameness and discomfort before, 12 weeks after, and 52 weeks after the APS injection.

Results—The APS group had significant improvements in lameness grade, asymmetry indices of vertical peak force, and range of joint motion by 14 days, compared with baseline or control group values. No adverse effects associated with APS treatment were evident. Clients assessed lameness and comfort as improved at 12 and 52 weeks. The APS had greater likelihood (OR, 4.3 to 30.0) of a therapeutic response in horses with a lameness score < 4, < 10% vertical force asymmetry, or absence of marked osteophyte formation, subchondral sclerosis, or joint space narrowing. Concentration of interleukin-1 receptor antagonist in APS was 5.8 times that in blood.

Conclusions and Clinical Relevance—Intra-articular administration of APS can be considered an effective treatment option for equine osteoarthritis, with the potential for disease-modifying effects.

Contributor Notes

Supported by Biomet Biologics, the 2011 summer research scholarship at The Ohio State University College of Veterinary Medicine, and the animal science internship program at The Ohio State University.

Presented in abstract form in the proceedings of the American College of Veterinary Surgeons Veterinary Symposium, National Harbor, Md, November 2012. Presented in abstract form at the 3rd North American Veterinary Regenerative Medicine Association Annual Meeting, Savannah, Ga, November 2012.

The authors thank Krista O'Shaughnessey and Jacy Hoeppner for product technical support; Megan Cline, Stephanie Vijan, Jill Stephens, Melissa Roemer, Lauren Eisemann, Rachel Wermertm, and Rebekah Sanchez-Hodge for technical assistance; and Drs. Harold Kemp, Jane Kennedy, Jim Chase, Patricia Balzer, Peter Meuse, Brett Berthold, Chris Beinlich, Don Palmer, Hugh Worsham, John Stanek, Keith Brown, Robert Schwartz, Thomas Beckman, Thomas Walrond, William Gesel, and William Wise for patient referral.

Address correspondence to Dr. Bertone (bertone.1@osu.edu).